Abstract
BACKGROUND: A coronary sinus reducer (CSR) is an hourglass-shaped stainless steel stent that is percutaneously inserted in the coronary sinus. It improves myocardial perfusion by narrowing the coronary sinus and dilating the arterioles into the ischemic subendocardium. CASE SUMMARY: A 79-year-old man with chronic coronary syndrome, previously implanted with a cardiac resynchronization therapy and defibrillator (CRT-D), presented to our hospital for refractory angina. He was under optimized medical therapy and not amenable to further revascularization. Therefore, a CSR was implanted. DISCUSSION: CSR implantation in patients with CRT-D is not currently defined by any guidelines. It might be a challenging procedure that can damage or dislocate the resynchronization lead, and data in literature are limited to case reports. TAKE-HOME MESSAGES: Refractory angina is a serious epidemiologic issue that greatly limits patients' quality of life. CSR implantation appears to be a safe and effective procedure even in patients with CRT-D.